IUD (intrauterine device)

What is an IUD? Intrauterine Devices (IUDs) are small, T-shaped contraceptive devices that provide long term birth control. There are 2 different types: ParaGard (Copper T) - made of flexible plastic and wrapped in copper, this device is hormone free and lasts for 10 years. Mirena - also made of flexible plastic, this device contains the hormone progestin and lasts for 5 years.

What is an IUD? An IUD prevents sperm from joining with an egg by affecting how the sperm move. It also thickens cervical mucus to inhibit sperm from passing through & changes the lining of the uterus which prevents egg implantation.

IUDs do NOT protect you from STDs

What about insertion? IUDs must be inserted by a healthcare provider. Before insertion, you must have a consultation with your provider, be informed of the pros and cons and be screened for gonorrhea and Chlamydia.

Your provider may suggest you take ibuprofen before your insertion visit. Some women may experience pain, bleeding and/or dizziness during and after placement. This will normally go away after a few hours.

Insertion is more comfortable if performed when you are on your menstrual cycle.

In the Exam Room Your vagina will be held open with a speculum and your cervix will be stabilized with a tenaculum. Your uterus will be measured to see if you are a good fit for an IUD. If so, the IUD will be inserted.

Many women report feeling discomfort including cramps during insertion. Let your physician know how you are feeling.

A sanitary pad will be provided for you since there will likely be some bleeding/spotting afterwards.

Following insertion? It is okay to have sexual intercourse as soon as you feel comfortable after your IUD is inserted (unless your IUD has been inserted within 48 hours after giving birth).

ParaGard provides pregnancy prevention immediately after insertion.

Mirena IUDs are effective immediately only if inserted within 7 days after the start of your period. If you have Mirena inserted at any other time during your menstrual cycle, you should use another method of birth control during the first week after insertion (such as a condom). Pregnancy protection will begin after 7 days.

Some healthcare professionals recommend using a condom as a backup method during the first month after your insertion to reduce your risk of infection.

Follow-Up 4-8 weeks after insertion you should have a follow-up visit scheduled with your provider to make sure everything is ok with your IUD. You should also feel for the strings yourself after every period to make sure it is still in place. Pros? • Prevents pregnancy 99.9% of the time • Can be used continuously for years • Private and discreet • The ability to become pregnant returns quickly after removal • Can be removed early if you desire to become pregnant • It is the most inexpensive long-term reversible available method of contraception • A good alternative for those women who have problems with traditional hormonal methods of birth control • ParaGard can be used while breast feeding • Mirena can reduce menstrual cramps and the amount of bleeding that accompanies a woman's period (some women will stop having periods after about a year) • IUD has the highest rate of satisfaction out of all birth control methods

Cons? • Possible heavy bleeding and cramping immediately after insertion • Up front costs • Possible irregular bleeding or spotting for the first few months after insertion. • For women on ParaGard , potential for heavier bleeding and cramping during periods

Can anyone get an IUD? You should NOT get an IUD if you: • might be pregnant • have certain STDs • have untreated cervical cancer • have abnormal vaginal bleeding • have a serious pelvic infection • have a condition that distorts the shape of the uterus • have breast cancer • have liver disease • have a weakened immune system (due to HIV, leukemia, or IV drug use)

Possible complications? Serious problems are rare, but there are some issues to be aware of: • Perforation : An IUD can, very rarely, be pushed through the uterus wall during insertion. • Infection : Pelvic infection can be caused by bacteria getting into the uterus during insertion. Most infection develops within three weeks of insertion. Infection after three weeks is very rare and is most likely due to exposure to STDs during sexual intercourse. • Expulsion : IUDs can partially or completely slip out of the uterus. This is more likely to happen in younger women, women who have never had a baby, and during the first few months of use. If this occurs, you can become pregnant, so use back-up birth con- trol (e.g. condoms) and call your doctor.

Call your provider immediately if you... • notice any change in the length of the string • have pain or bleeding after intercourse • think you are pregnant • might have been exposed to an STD • have heavy bleeding, cramps, fever, chills or unusual vaginal discharge What about side effects? Women may experience side effects, but in most cases, they will go away after the first few weeks to months. Side effects include: • Changes to menstrual flow and spotting between first few periods • Lower abdominal pain and/or back pain • Nausea • Acne • Headaches • Mood changes • Breast tenderness • Ovarian cysts have been diagnosed in a small percent of IUD users

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Rev. 01/13